Fluorescence‐guided cancer surgery—A new paradigm

Thammineedi, Subramanyeshwar Rao; Saksena, Ajesh Raj; Nusrath, Syed; Iyer, R. Rajagopalan; Shukla, Srijan; Patnaik, Sujit Chyau; Reddy, R Pratap; Boleneni, Naren; Sharma, Rakesh; Smith, Lynette M.; Are, Chandrakanth

doi:10.1002/jso.26469

Cited by 21 publications

(28 citation statements)

References 83 publications

(87 reference statements)

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“…The preoperative superselective transarterial delivery of a lipidol-indocyanine green (ICG) mixture to trace endophytic tumours has been described [3,15], but related transarterial liquid diffusion and allergy must be taken into account. Additionally, intraoperative real-time localization has greater prospects for development; however, this method is not currently widely applied due to the high cost and prolonged operation time [4]. There have also been case reports on the application of hook-wire localization prior to laparoscopic partial nephrectomy for an intrarenal mass [5,16,17]; nevertheless, persistent pain is problematic.…”

Section: Discussionmentioning

confidence: 99%

“…Small, totally endophytic renal masses present a technical challenge for surgical extirpation due to poor identi ability during surgery. There are dozens of technology-enhanced methods for tumour localization in several surgical specialities [1][2][3][4][5]. However, the method for the precise localization of totally endophytic tumours before nephron-sparing surgery could be optimized.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous microcoil localization of a small, totally endophytic renal mass for nephron-sparing surgery: A case report and literature review

Su,

Zhang,

Zhao

et al. 2022

Preprint

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Background: Small, totally endophytic renal masses present a technical challenge for surgical extirpation due to poor identifiability during surgery. The method for the precise localization of totally endophytic tumours before nephron-sparing surgery could be optimized. Case presentation: An asymptomatic 70-year-old male presented with a right-sided, 16-mm, totally endophytic renal mass on computed tomography (CT). CT-guided percutaneous microcoil localization was carried out prior to laparoscopy to provide a direction for partial nephrectomy. During the 25 minutes of the localization procedure, the patient underwent five local CT scans, and his cumulative effective radiation dosage was 5.1 mSv. The span between localization and the start of the operation was 15 hours. The laparoscopic operation time was 105 minutes, and the ischaemia time was 25 minutes. The postoperative recovery was smooth, and no perioperative complications occurred. Pathology showed the mass to be renal clear cell carcinoma, WHO/ISUP grade 2, with a 2-mm, clear surgical margin. The patient remained free of recurrence on follow-up for eleven months. To our knowledge, this application of microcoil implantation prior to laparoscopic partial nephrectomy towards an intrarenal mass could be an early reported attempt for the localized method applied in renal surgery. Conclusions: The percutaneous microcoil localization of endophytic renal tumours is potentially safe and effective prior to laparoscopic partial nephrectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Percutaneous microcoil localization of a small, totally endophytic renal mass for nephron-sparing surgery: A case report and literature review

Su,

Zhang,

Zhao

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…The preoperative superselective transarterial delivery of a lipidol-indocyanine green (ICG) mixture to trace endophytic tumours has been described ( 3 , 18 ), but related transarterial liquid diffusion and allergy must be taken into account. Additionally, intraoperative real-time localization has greater prospects for development; however, this method is not currently widely applied due to the high cost and prolonged operation time ( 4 ). It is understandable that 3D models may help in characterizing tumor ( 19 ), but 3D virtual model reconstruction still needs a rigorous and acknowledged methodology for clinical practice ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Microcoil Localization of a Small, Totally Endophytic Renal Mass for Nephron-Sparing Surgery: A Case Report and Literature Review

Zhang

Zhao

et al. 2022

Front. Oncol.

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Small, totally endophytic renal masses present a technical challenge for surgical extirpation due to poor identifiability during surgery. The method for the precise localization of totally endophytic tumours before nephron-sparing surgery could be optimized. An asymptomatic 70-year-old male presented with a right-sided, 16-mm, totally endophytic renal mass on computed tomography (CT). CT-guided percutaneous microcoil localization was carried out prior to laparoscopy to provide a direction for partial nephrectomy. During the 25 minutes of the localization procedure, the patient underwent five local CT scans, and his cumulative effective radiation dosage was 5.1 mSv. The span between localization and the start of the operation was 15 hours. The laparoscopic operation time was 105 minutes, and the ischaemia time was 25 minutes. The postoperative recovery was smooth, and no perioperative complications occurred. Pathology showed the mass to be renal clear cell carcinoma, WHO/ISUP grade 2, with a 2-mm, clear surgical margin. The patient remained free of recurrence on follow-up for eleven months. To our knowledge, this application of microcoil implantation prior to laparoscopic partial nephrectomy towards an intrarenal mass could be an early reported attempt for the localized method applied in renal surgery. The percutaneous microcoil localization of endophytic renal tumours is potentially safe and effective prior to laparoscopic partial nephrectomy.

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“…In particular, Storz (NIR/ICG) and Fluobeam 800 imaging systems are the two most used devices in studies investigating parathyroid autofluorescence. The Storz (NIR/ICG) imaging system serves as an extension to an existing Storz endoscopic tower, which makes it a versatile and cost‐effective tool as it can be used in other fluorescence‐guided thoracoscopic or laparoscopic surgery 17,37 . On the other hand, the Fluobeam 800 is a compact handheld device that can be incorporated in any operating theatre setting 38 .…”

Section: Literature Reviewmentioning

confidence: 99%

“…The Storz (NIR/ICG) imaging system serves as an extension to an existing Storz endoscopic tower, which makes it a versatile and cost-effective tool as it can be used in other fluorescence-guided thoracoscopic or laparoscopic surgery. 17,37 On the other hand, the Fluobeam 800 is a compact handheld device that can be incorporated in any operating theatre setting. 38 Both devices have an easy learning curve, which improves the anatomical localisation of parathyroid glands without significantly increasing operative time.…”

Section: Near-infrared-induced Autofluorescence Of Parathyroid Glandsmentioning

confidence: 99%

Methods of identification of parathyroid glands in thyroid surgery: A literature review

Tjahjono

Nguyen

Phung

et al. 2021

ANZ Journal of Surgery

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Intra-operative identification and preservation of parathyroid glands is an important but challenging aspect of thyroid surgery. Failure to do so may lead to transient or permanent hypocalcaemia, where the latter represents a serious complication causing life-long morbidity. It would be beneficial, therefore, if a simple and reliable modality can be developed to assist in the identification of parathyroid glands intra-operatively. The aim of this literature review is to provide an overview of intra-operative modalities used to identify parathyroid glands with a particular focus on near-infrared autofluorescence (NIRAF). Twenty-seven studies were considered relevant in this literature review. Several modalities have been used to aid parathyroid gland identification, including Raman spectroscopy, indocyanine green angiography, and NIRAF. NIRAF technology allows parathyroid glands to spontaneously give off light (autofluorescence) when exposed to near-infrared light at a wavelength of 785 nm, creating a contrast between tissues to allow intra-operative differentiation. Studies utilising NIRAF technology were able to identify 76.3%-100% of parathyroid glands intraoperatively. Furthermore, two randomised controlled trials comparing NIRAF and white light showed that the use of NIRAF was able to significantly increase the mean number of parathyroid glands detected and reduce the incidence of post-operative hypocalcaemia. NIRAF is an emerging tool that has been shown to increase the number of intra-operative parathyroid gland identification and reduce the rate of post-operative hypocalcaemia in a safe and reproducible manner. Future trials are needed to evaluate the real-life impact of NIRAF technology in outcomes of patients following thyroid surgery.

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Fluorescence‐guided cancer surgery—A new paradigm

Cited by 21 publications

References 83 publications

Percutaneous microcoil localization of a small, totally endophytic renal mass for nephron-sparing surgery: A case report and literature review

Percutaneous microcoil localization of a small, totally endophytic renal mass for nephron-sparing surgery: A case report and literature review

Percutaneous Microcoil Localization of a Small, Totally Endophytic Renal Mass for Nephron-Sparing Surgery: A Case Report and Literature Review

Methods of identification of parathyroid glands in thyroid surgery: A literature review

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